Daisy C. Carreon

Confrontation and loss of control: Masculinity and men's fear in public space

Abstract Existing research typically examines fear in public space from womens perspectives. To date, environment–behavior researchers have largely overlooked mens fear in public space, and the role of masculinity in shaping mens perceptions of fear and safety. This paper investigates the intersections of traditional, dominant masculinity—or masculinism—and mens fear in public space, based on interviews with 82 undergraduate men students. Masculinism features qualities such as control, competition, aggression, and physical strength. We argue that, for many men, public spaces and situations that challenge this masculinist identity may generate fear. Similarly, spaces and situations that promote feelings of safety do so, in part, by bolstering this identity. We employ the lens of masculinity to explore mens feelings of fear of the unknown, heightened awareness and safety, fear of confrontation, and safety in numbers. Conclusions examine implications for the development of masculinity and recommendations for future research.

Role of community risk factors and resources on breast carcinoma stage at diagnosis

The current study investigated the individual and community determinants of breast carcinoma stage at diagnosis (BCSAD) using multiple data sources merged with cancer registry data. The literature review yielded 5 studies that analyzed cancer registry data merged with community‐level variables (1995–2004).

Neighborhood socio-economic disadvantage and race/ethnicity as predictors of breast cancer stage at diagnosis

BackgroundThis study investigated the role of key individual- and community-level determinants to explore persisting racial/ethnic disparities in breast cancer stage at diagnosis in California during 1990 and 2000.MethodsWe examined socio-demographic determinants and changes in breast cancer stage at diagnosis in California during 1990 and 2000. In situ, local, regional, and distant diagnoses were examined by individual (age, race/ethnicity, and marital status) and community (income and education by zip code) characteristics. Community variables were constructed using the California Cancer Registry 1990-2000 and the 1990 and 2000 U.S. Census.ResultsFrom 1990 to 2000, there was an overall increase in the percent of in situ diagnoses and a significant decrease in regional and distant diagnoses. Among white and Asian/Pacific Islander women, a significant percent increase was observed for in situ diagnoses, and significant decreases in regional and distant diagnoses. Black women had a significant decrease in distant -stage diagnoses, and Hispanic women showed no significant changes in any diagnosis during this time period. The percent increase of in situ cases diagnosed between 1990 and 2000 was observed even among zip codes with low income and education levels. We also found a significant percent decrease in distant cases for the quartiles with the most poverty and least education.ConclusionsHispanic women showed the least improvement in breast cancer stage at diagnosis from 1990 to 2000. Breast cancer screening and education programs that target under-served communities, such as the rapidly growing Hispanic population, are needed in California.

Reforming dental workforce education and practice in the USA

The USA dental education programmes are facing challenges similar to those confronting countries around the globe, particularly amongst the industrialised nations. The purpose of this study was to evaluate the educational programmes of 15 USA dental schools to determine their impact on improving workforce diversity and oral health care access. The study investigates the predictors of public service plans of dental school seniors in Pipeline and non-Pipeline Program dental schools. We analysed baseline and post-intervention data collected in the American Dental Education Association (ADEA) Annual Survey of Dental School Seniors and a set of contextual variables. Public service plans (dependent variable) was predicted by four types of independent variables: intervention, contextual, community-based dental education (CBDE), and student characteristics. Findings from the study show that access to a state or federally sponsored loan repayment program was the most significant predictor of public service plans and that increasing educational debt was the most significant barrier. In the short-term we may be able to sustain the USA loan repayment programs to motivate senior dental students to provide public service to address the oral health care access crisis. However, in the long-term, a new workforce development initiative will be required to transform dental education and practice, modelled after the well-respected licensure programmes for Physician Assistants and/or Advanced Practice Registered Nurses, to expand oral health care access, particularly amongst vulnerable population subgroups, such as low-income children and families.

Questioning the Salicylates and Influenza Pandemic Mortality Hypothesis in 1918–1919

To the Editor—Starko [1] presented an original and creative idea to explain a continuing medical mystery, the extreme virulence of the 1918–1919 influenza pandemic. Her hypothesis, that the use of salicylates exacerbated the tendency of the infection to produce fluid in the lungs, has face validity and is supported by anecdotal evidence of widespread use of aspirin in the United States during the pandemic. The international characteristics of the pandemic make the salicylate hypothesis difficult to sustain as the primary explanation for the unusual virulence of the 1918–1919 influenza pandemic. Worldwide, an estimate of the mortality of the 1918–1919 pandemic is 50 million deaths, with a range of up to 100 million deaths [2]. Taking the 50 million figure, this was about 2.5% of the world population. By contrast, in the United States, mortality was on the order of 0.5%. Clearly, the rest of the world was struck more severely, on average, than the United States. India serves as a useful vignette. Mortality in India was staggering, with estimates of 18.5 million persons dead [3] and higher [4]. Indeed, the Indian peasant population was so severely affected that economics Nobel laureate Theodore W. Schultz used the pandemic as a natural experiment in per capita agricultural output [5]. Given the huge number of deaths in India and the burden among subsistence agricultural workers, it is extremely implausible that salicylates played an exacerbating role in anything other than a trivial percentage of Indian mortality. Thus, Starko’s intriguing hypothesis fails the test of dose-response. That is to say, in countries such as the United States, where salicylates were more available, mortality was much lower compared with regions where salicylates were less readily available. These observations are at the ecological level, and such comparisons are notoriously susceptible to confounding. However, if the salicylate hypothesis applies universally, then the ecological confounding would have to operate such that the salicylate-influenza connection is stronger in countries with less access to aspirin, which seems a priori unlikely. Indeed, the overwhelming majority of the millions of Indian peasants who were killed by the flu certainly had no access to salicylates whatsoever. If the salicylate hypothesis only works in the United States and in similar settings, then we question its validity given the worldwide scope of severe mortality in 1918–1919.